Niamh Smyth
Ceist:399. Deputy Niamh Smyth asked the Minister for Health the status of an operation for a person (details supplied); and if he will make a statement on the matter. [5784/18]
Amharc ar fhreagraHospital Appointments Status
Ceisteanna (399)
Freagraí scríofa
Under the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.
The National Waiting List Management Policy, A standardised approach to managing scheduled care treatment for in-patient, day case and planned procedures, January 2014, has been developed to ensure that all administrative, managerial and clinical staff follow an agreed national minimum standard for the management and administration of waiting lists for scheduled care. This policy, which has been adopted by the HSE, sets out the processes that hospitals are to implement to manage waiting lists.
In relation to the particular query raised, as this is a service matter, I have asked the HSE to respond to you directly.
Drugs Payment Scheme
Ceisteanna (400)
Seán Sherlock
Ceist:400. Deputy Sean Sherlock asked the Minister for Health the reason a medicine has been withdrawn from a person (details supplied) [5787/18]
Amharc ar fhreagraFreagraí scríofa
Medicines play a vital role in improving the health of Irish patients. Securing access to existing and new and innovative medicines is a key objective of the health service. However, the challenge is to do this in an affordable and sustainable manner. The medicines bill for the community drugs schemes – primarily the GMS, Long Term Illness and Drugs Payment schemes and the High Tech Arrangement – was approximately €1.8 billion in 2017.
To ensure patients receive the highest quality care, resources invested in medicines must be used efficiently and effectively. This requires an integrated approach to secure best value for money for all treatments, greater efficiencies in the supply chain and the use of the most cost-effective treatments.
Lidocaine 5% medicated plaster is licensed for the symptomatic relief of neuropathic pain associated with previous herpes zoster (shingles) infection, known as post-herpetic neuralgia (PHN), in adults. It has been reimbursed in the community drugs schemes since 2010. The projected budget impact on introduction was low due to the specific licensed indication but total expenditure has increased significantly, from €9.4 million in 2012 to over €30 million in 2016, mainly from off-license use for pain not associated with shingles.
An HSE Medicines Management Programme (MMP) review of this product highlighted that the clinical evidence for its use in PHN is limited due to lack of comparative data, and its value is uncertain for all other types of pain. The National Centre for Pharmacoeconomics estimated that, in Ireland, only 5-10% of prescribing of this product has been for the licensed indication of PHN.
Following the MMP review, the HSE introduced a new reimbursement system for the product from 1 September 2017. This process supports its appropriate use, ensuring that PHN patients continue to receive this treatment. The HSE estimates that this protocol will reduce annual expenditure on this product by approximately 90%.
Under the protocol, all patients who were receiving antivirals for shingles were automatically approved for the lidocaine medicated plaster for three months. No action was required by GPs and the patient’s pharmacy was notified of his or her approval status.
These patients were identified and automatically registered on the HSE-PCRS system for three months and continued to receive the treatment from their pharmacy until 30 November 2017. However, since 1 December 2017, non-shingles patients no longer receive this item under the community drugs schemes. The HSE has produced information leaflets for patients and advised GPs on treatment alternatives.
In exceptional circumstances, the product may be approved for supply through the community schemes for unlicensed indications. GPs apply for reimbursement for unlicensed indications through the online system. The MMP reviews applications before a decision is made and communicated to the GP.
Full details of the review are available on the HSE website at http://hse.ie/eng/about/Who/clinical/natclinprog/medicinemanagementprogramme/yourmedicines/lidocaine-plaster/lidocaine-medicated-plaster.html .
This decision is a matter for the HSE. However, I fully support the objectives of the HSE Medicines Management Programme.
State Claims Agency Data
Ceisteanna (401)
Clare Daly
Ceist:401. Deputy Clare Daly asked the Minister for Health further to Parliamentary Question No. 418 of 30 January 2018, if the State Claims Agency maintains records in different formats of confidential settlements (details supplied) that are made in cases. [5788/18]
Amharc ar fhreagraFreagraí scríofa
While the State Claims Agency does not record details of confidentiality clauses on its IT system my Department has been advised that such details are captured on the paper records associated with settled claims. Furthermore, the Agency states that any related search would require a manual review of all paper files for the period 2010 to 2017.
Health Insurance Community Rating
Ceisteanna (402)
Richard Boyd Barrett
Ceist:402. Deputy Richard Boyd Barrett asked the Minister for Health his plans to extend the lifetime community rating scheme to make credits available to persons on low incomes who qualified for medical cards from 2008 and to those who had health insurance prior to 2004 in cases in which insurance companies no longer hold records of these persons; and if he will make a statement on the matter. [5794/18]
Amharc ar fhreagraFreagraí scríofa
Lifetime Community Rating (LCR) was introduced in 2015 as a way to strengthen Ireland’s community rated-health insurance market, where people who are old or sick do not have to pay more than the young and healthy when taking out a health insurance policy. The aim behind LCR was to ensure sufficient balance in the market overall between older people and younger people, between those who tend to claim more and those who tend to claim less, and thereby ensure the sustainability of the community rated approach. LCR encourages more young people to take out health insurance as a way to avoid late entry loadings of 2% per annum which may apply at age 35 and older.
While approximately 45% of Irish people hold private health insurance, everyone – with or without insurance - is entitled to access healthcare via the public health system.
Under the legislation, credits are available in certain circumstances, but only to persons who have held private health insurance. Currently, provision is made for an allowance of up to three years for persons who held insurance in the State but then had to give up their insurance as a result of redundancy for a period occurring after 1 January 2008.
The Health Insurance (Amendment) Act 2017 and forthcoming regulations will enhance the existing system of Lifetime Community Rating loadings: by extending this existing redundancy provision to apply to other scenarios; by ensuring that anyone living or travelling abroad for more than 6 months will not be loaded upon their return (provided they become insured upon their return); by ensuring that members of the Defence Forces are credited for their time in service; and by applying any loadings incurred for 10 years rather than for life, as is currently the case.
Health insurers are required to hold records for 6 years, in line with the legal obligation for retention of such records as part of general data protection requirements. For the purposes of Lifetime Community Rating beyond this 6 year timeframe, the onus is on the individual to provide evidence that satisfies the insurer of their previous health insurance cover.
Home Care Packages Provision
Ceisteanna (403, 404)
John Curran
Ceist:403. Deputy John Curran asked the Minister for Health the way in which he plans to increase home care packages and home help hours to older persons to resolve overcrowding in hospitals; and if he will make a statement on the matter. [5796/18]
Amharc ar fhreagraJohn Curran
Ceist:404. Deputy John Curran asked the Minister for Health his plans to achieve the roll-out of additional home care packages; the deadlines and timeframe for same; and if he will make a statement on the matter. [5797/18]
Amharc ar fhreagraFreagraí scríofa
I propose to take Questions Nos. 403 and 404 together.
As these are service matters I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
Primary Care Centres Provision
Ceisteanna (405, 406)
John Curran
Ceist:405. Deputy John Curran asked the Minister for Health the status of a primary care centre in Clondalkin village, Dublin 22; and if he will make a statement on the matter. [5803/18]
Amharc ar fhreagraJohn Curran
Ceist:406. Deputy John Curran asked the Minister for Health the status of a primary care centre in Lucan, County Dublin; and if he will make a statement on the matter. [5804/18]
Amharc ar fhreagraFreagraí scríofa
I propose to take Questions Nos. 405 and 406 together.
As the HSE has responsibility for the provision, along with the maintenance and operation of Primary Care Centres and other Primary Care facilities, the Executive has been asked to reply directly to the Deputy.
Primary Care Centres Provision
Ceisteanna (407)
John Curran
Ceist:407. Deputy John Curran asked the Minister for Health the status of a primary care centre in Rowlagh, Clondalkin, Dublin 22; and if he will make a statement on the matter. [5805/18]
Amharc ar fhreagraFreagraí scríofa
My Department has asked the Health Service Executive to provide the Deputy with the current status of this capital project.
Medical Card Eligibility
Ceisteanna (408)
Pat Buckley
Ceist:408. Deputy Pat Buckley asked the Minister for Health the reason for refusing persons with MS to be recognised as having a debilitating illness and so receive needed support such as a medical card. [5820/18]
Amharc ar fhreagraFreagraí scríofa
Medical card provision is solely based on financial assessment. In accordance with the provisions of the Health Act 1970 (as amended), eligibility for a medical card is determined by the HSE. The Act obliges the HSE to assess whether a person is unable, without due hardship, to arrange general practitioner services for himself or herself and his or her family, having regard to his or her overall financial position and reasonable expenditure and every application must be assessed on that basis. Under the legislation, having a particular illness, in itself, does not establish eligibility for a medical card and therefore, the medical conditions of applicants for this scheme are not monitored on that basis. Where the applicant's income is within the income guidelines, a medical card or GP visit card will be awarded.
Every effort is made by the HSE, within the framework of the legislation, to support applicants in applying for a medical card and, in particular, to take full account of the difficult circumstances in the case of applicants who may be in excess of the income guidelines. It should be noted, in certain circumstances, the HSE may exercise discretion and grant a medical card, even though an applicant exceeds his or her income threshold, where he or she faces difficult financial circumstances, such as extra costs arising from an illness. Social and medical issues are considered when determining whether undue hardship exists for an individual accessing general practitioner or other medical services. The HSE affords applicants the opportunity to furnish supporting information documentation to fully take account of all the relevant circumstances that may benefit them in the assessment, including medical evidence of cost and necessary expenses.
Multiple Sclerosis is one of the conditions covered by the Long Term Illness Scheme (LTI). Under the scheme, patients receive drugs, medicines, and medical and surgical appliances directly related to the treatment of their illness, free of charge. For people who are not eligible for the LTI scheme, there are other arrangements which protect them from excessive medicine costs.
Under the Drug Payment Scheme, no individual or family pays more than €144 a month towards the cost of approved prescribed medicines. The scheme significantly reduces the cost burden for families and individuals with ongoing expenditure on medicines.
Departmental Staff Data
Ceisteanna (409)
Clare Daly
Ceist:409. Deputy Clare Daly asked the Minister for Health the number of secondees from companies (details supplied) that are working in his Department. [5836/18]
Amharc ar fhreagraFreagraí scríofa
There are no secondees from the named companies working in my Department nor are there any staff from the named companies engaged in contract work in my Department.
Hospital Appointments Status
Ceisteanna (410)
Pearse Doherty
Ceist:410. Deputy Pearse Doherty asked the Minister for Health when a person (details supplied) in County Donegal will have a procedure carried out; and if he will make a statement on the matter. [5853/18]
Amharc ar fhreagraFreagraí scríofa
Under the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.
The National Waiting List Management Policy, A standardised approach to managing scheduled care treatment for in-patient, day case and planned procedures, January 2014, has been developed to ensure that all administrative, managerial and clinical staff follow an agreed national minimum standard for the management and administration of waiting lists for scheduled care. This policy, which has been adopted by the HSE, sets out the processes that hospitals are to implement to manage waiting lists.
In relation to the particular query raised, as this is a service matter, I have asked the HSE to respond to you directly.
Long-Term Illness Scheme Eligibility
Ceisteanna (411)
Jack Chambers
Ceist:411. Deputy Jack Chambers asked the Minister for Health his plans to include persons with Parkinson's disease on the long-term illness scheme; and if he will make a statement on the matter. [5862/18]
Amharc ar fhreagraFreagraí scríofa
The LTI Scheme was established under Section 59(3) of the Health Act 1970 (as amended). The conditions covered by the LTI are: acute leukaemia; mental handicap; cerebral palsy; mental illness (in a person under 16); cystic fibrosis; multiple sclerosis; diabetes insipidus; muscular dystrophies; diabetes mellitus; parkinsonism; epilepsy; phenylketonuria; haemophilia; spina bifida; hydrocephalus; and conditions arising from the use of Thalidomide. Under the LTI Scheme, patients receive drugs, medicines, and medical and surgical appliances directly related to the treatment of their illness, free of charge.
There are no plans to extend the list of conditions covered by the Scheme.
Disability Services Provision
Ceisteanna (412, 413)
Donnchadh Ó Laoghaire
Ceist:412. Deputy Donnchadh Ó Laoghaire asked the Minister for Health the cost per year of caring for a person with acute locked-in syndrome in an institutional setting. [5863/18]
Amharc ar fhreagraDonnchadh Ó Laoghaire
Ceist:413. Deputy Donnchadh Ó Laoghaire asked the Minister for Health the facilities including space availability in the HSE south area which could provide acute care for a person with locked-in syndrome. [5864/18]
Amharc ar fhreagraFreagraí scríofa
I propose to take Questions Nos. 412 and 413 together.
The Government is committed to providing services and supports for people with disabilities which will empower them to live independent lives, provide greater independence in accessing the services they choose and enhance their ability to tailor the supports required to meet their needs and plan their lives. This commitment is outlined in the Programme for Partnership Government, which is guided by two principles: equality of opportunity and improving the quality of life for people with disabilities.
As the Deputy's questions relate to service matters, I have arranged for the questions to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.
Hospital Waiting Lists
Ceisteanna (414)
Donnchadh Ó Laoghaire
Ceist:414. Deputy Donnchadh Ó Laoghaire asked the Minister for Health the timeframe for direct referral for oncology patients to the oncology ward to be implemented in Cork University Hospital [5865/18]
Amharc ar fhreagraFreagraí scríofa
The Deputy's question relates to service delivery matters and accordingly I have asked the HSE to respond directly to him.
Health and Social Care Professionals Regulation
Ceisteanna (415)
Róisín Shortall
Ceist:415. Deputy Róisín Shortall asked the Minister for Health further to Parliamentary Question No. 920 of 13 July 2017, the position regarding the registration and regulation of complementary therapists, including hypnotherapists; if the draft regulations have been submitted to the Houses of the Oireachtas by his Department; and if he will make a statement on the matter. [5866/18]
Amharc ar fhreagraFreagraí scríofa
Further to my response to Parliamentary Question No. 920 of 2017, there remains no statutory regulation of complementary therapists, including hypnotherapists, in Ireland. Although not subject to professional statutory regulation, complementary therapists are subject to a range of legislation and regulation similar to other practitioners, including consumer legislation, competition, contract and criminal law.
The report of the National Working Group on the Regulation of Complementary Therapists was published in 2005. As previously advised, Department policy has been informed by this Report and, while considering it, the Department of Health has supported greater voluntary self-regulation of complementary therapy.
The immediate priority for the Department is the establishment of the boards of the remaining professions designated under the Health and Social Care Professionals Act 2005, including the newly designated professions of counsellor and psychotherapist. It is proposed that, when all the registration boards have been established towards the end of 2018, the Department will ask the Health and Social Care Professionals Council (CORU) to prepare a risk assessment, in terms of public protection, of the principal health and social care professions seeking designation under the Act and to make recommendations concerning options or their possible future regulation.
Disability Support Services Funding
Ceisteanna (416)
Éamon Ó Cuív
Ceist:416. Deputy Éamon Ó Cuív asked the Minister for Health his plans to provide increased funding for an organisation (details supplied) in 2018 in view of its requirement for extra funding; and if he will make a statement on the matter. [5881/18]
Amharc ar fhreagraFreagraí scríofa
The Government is committed to providing services and supports for people with disabilities which will empower them to live independent lives, provide greater independence in accessing the services they choose, and enhance their ability to tailor the supports required to meet their needs and plan their lives. This commitment is outlined in the Programme for Partnership Government, which is guided by two principles: equality of opportunity and improving the quality of life for people with disabilities.
As the Deputy's question relates to service matters, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.